Orthopaedic surgery

• What is the main focus of equine orthopaedic surgery?

  To treat bones and joints in horses
• What are the two main uses of arthroscopy?

  Diagnostic and therapeutic
• What does arthroscopy enable visualization of?

  It enables visualization within the joint and soft tissue structures
• Why are cartilage lesions significant in arthroscopy?

  They are not visible radiographically
• What are the therapeutic uses of arthroscopy?

  • Treat osteochondritis dissecans/chip fractures
  • Remove osteochondral fragments
  • Debride cartilage lesions
  • Perform lavage for synovial sepsis
  • Remove bacterial debris and contaminated tissue
• What is the first step in the arthroscopy technique?

  General anaesthetic
• What is the purpose of sterile preparation in arthroscopy?

  To prevent infection during the procedure
• What technique is used in arthroscopy for instrument insertion?

  Triangulation technique
• What are the types of arthroscopic procedures mentioned?

  • Arthroscopy: within a joint
  • Bursoscopy: within a bursa
  • Tenoscopy: within a tendon sheath
• What is synovitis?

  Inflammation of the synovial membrane
• What are some intra-operative risks of arthroscopy?

  Haemarthrosis and obstruction of view by synovial villi
• What are some post-operative complications of arthroscopy?

  Infection and failure to remove fragments
• What are the options for managing fractures in horses?

  • Conservative treatment
  • Surgical removal
  • Surgical repair
  • Euthanasia
• What is a common indication for surgical removal of fractures?

  Comminuted fractures
• What are the key components of equine fracture repair?

  • General anaesthesia
  • Strict surgical asepsis
  • Pre-operative planning
  • AO/ASIF fixation systems
  • Intra-operative radiography
  • Bandage or cast for recovery
• What are some intra-operative complications of equine fracture repair?

  Myositis and soft tissue damage
• What are some post-operative complications of equine fracture repair?

  Fracture on recovery and infection
• What is arthrodesis?

  Fusion of bones of a joint
• In which joints does arthrodesis yield the best outcomes?

  Low-motion joints
• What is the indication for pastern arthrodesis?

  Low motion joint issues
• What is the indication for tarsal arthrodesis?

  Osteoarthritis of TMT and DIT joints not responding to medical therapy
• What is "kissing spines" in equine orthopaedics?

  Impingement/overriding of dorsal spinous processes
• What are the surgical techniques for treating impinging dorsal spinous processes?

  • Surgical ostectomy
  • Interspinous ligament desmotomy
• What are the differences in recovery time and invasiveness between surgical ostectomy and interspinous ligament desmotomy?

  • Surgical ostectomy:
  • More prolonged recovery (approx. 6 months)
  • More invasive
  • Interspinous ligament desmotomy:
  • Shorter recovery time (approx. 6-8 weeks)
  • Minimally invasive
• What is desmotomy?

  Surgical section of a ligament
• What is the indication for annular ligament desmotomy?

  Annular ligament constriction and DIP flexural deformity of the forelimb
• What are the two techniques for performing desmotomy?

  Open or endoscopically guided
• What is the prognosis for annular ligament desmotomy?

  Excellent, or good with hoof trimming
• What is the indication for periosteal transection?

  Angular limb deformity that is non-responsive to conservative treatment
• When should periosteal transection be performed?

  Before 2 months old during the active growth phase
• What is the technique for periosteal transection?

  Release of periosteal tissue on the epiphysis to stimulate growth
• What is the indication for tendon repair?

  Partial or complete severance of flexor tendon
• What is the technique for tendon repair?

  Aim for apposition of severed edges using various suture patterns
• What is the prognosis for tendon repair?

  Poor; it is a salvage procedure only
• What are the general principles of post-operative care for orthopaedic patients?

  • Use dressings/bandage to protect surgical site
  • Monitor for swelling or discharge
  • Post-op antibiotics may not be necessary
  • Provide analgesia, such as phenylbutazone
  • Remove sutures/staples around 7 days post-op
• How should movement be considered in the husbandry of post-operative patients?

  Consider the effect of movement on injury repair
• What dietary considerations should be made for post-operative patients?

  Provide a low energy diet
• What are the risks associated with post-operative care?

  Risk of colic and contralateral laminitis
• What should be monitored in cast management?

  • Integrity of the cast
  • Heat over joints
  • Swelling above the cast
  • Discharge through the cast
• How long should a cast be maintained for a comfortable/weight-bearing patient?

  For 2 weeks